Evidence-Based Decision-Making for a Public Health Emergency in China: Easier Said Than Done

• Date: 01 August 2020
• Published date: 01 August 2020
• DOI: 10.1177/0275074020942410
• Author: Liwei Zhang,Ji Zhao,Kelin Chen
• Subject Matter: Using COVID-19 to Advance Learning, Management, & Policy OutcomesEvidence-Based Decision Making for Public Health Management

https://doi.org/10.1177/0275074020942410

American Review of Public Administration

2020, Vol. 50(6-7) 720 –724

© The Author(s) 2020

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DOI: 10.1177/0275074020942410

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Evidence-Based Decision Making for Public Health Management

The novel infectious disease called coronavirus disease 2019

(COVID-19) was first identified in Wuhan, the capital of

China’s Hubei province. This disease spread swiftly throughout

China and globally. According to Johns Hopkins University and

the World Health Organization (WHO), as of April 27, 2020,

more than 3.04 million cases of COVID-19 have been reported

in 185 countries and territories, resulting in more than 211,000

deaths. More than 894,000 people have recovered (Johns

Hopkins Coronavirus Resource Center, 2020; WHO, 2020).

The COVID-19 outbreak has become a global public health

emergency and the only way to defeat this risk is with interna-

tional collaboration. However, due to the occurrence of

COVID-19, China’s government was accused of insufficient

emergency preparedness and a poor response by the interna-

tional community, although the Chinese government has con-

sistently declared that all reactions to the COVID-19 outbreak

were timely, including domestic risk management, interna-

tional information releases, and data sharing (“Pressured by

China, E.U. Softens Report on Covid-19 Disinformation,”

2020). Admittedly, during the initial stage of the outbreak, a

series of behaviors of the Chinese government harmed the

early response. On December 30, 2019, an ophthalmologist

used social media to announce that seven cases associated

with severe acute respiratory syndrome (SARS) had been

identified. This private whistleblowing was punished by the

police and official media asserted that the whistleblowing was

a rumor. This punishment became a focus of criticism from the

international community and the Chinese public, which

implies China’s misbehavior regarding information transpar-

ency in this public health emergency (“Chinese Doctor,

Silenced After Warning of Outbreak, Dies From Coronavirus,”

2020).

A policy of lockdown in Wuhan was issued on January 23,

2020. After that, cities of other provinces successively enforced

travel restrictions. Such strict measures are unprecedented, even

during the SARS outbreak in China in 2003. The mayor of

Wuhan said that locking down the whole city was a tough deci-

sion (“CCTV’s Interview to Wuhan Mayor Zhou Xianwang,”

2020). However, a prediction of the trend of COVID-19 in

China published in a peer-viewed journal indicates that if gov-

ernment control had been applied 5 days earlier, the epidemic

effectively would have been suppressed (Yang et al., 2020).

Among these questioning voices, Zeng Guang, a chief scientist

at the Chinese Center for Disease Control and Prevention

(CCDC), indirectly admitted that the main problem came from

local government’s decision-making. Zeng said that the govern-

ment is required to balance many factors, such as politics, social

stability, and the economy, and expert opinion is often partly

considered (Zhang et al., 2020). Therefore, through the lens of

China’s decision-making, it is critical to decipher what factors

are vital for consideration during decision-making.

942410ARPXXX10.1177/0275074020942410The American Review of Public AdministrationZhang et al.

research-article2020

1Jilin University, Changchun, China

2Shenzhen University, China

3Shanghai Jiao Tong University, China

Corresponding Author:

Ji Zhao, School of International and Public Affairs, Shanghai Jiao Tong

University, Xin Jian Building, Xuhui Campus, 1954 HuaShan Road, Xuhui

District, Shanghai 200030, China.

Email: jizhao@sjtu.edu.cn

Evidence-Based Decision-Making for

a Public Health Emergency in China:

Easier Said Than Done

Liwei Zhang1, Kelin Chen2, and Ji Zhao3

Abstract

This article aims to argue that evidence-based decision-making for a public health emergency is “easier said than done”

reflected on COVID-19 response in China. For the local government, the behavioral pattern is prone to blame-avoiding

instead of making decision following scientific evidence and experts’ advice. However, such behavior is not based on

completely subjective judgment but a rational choice for the local government. Some consequences associated with China’s

response to COVID-19 reveals an inflexible administrative system. Therefore, China’s governance reform should focus on

empowering local governments with more flexibility and resilience, which enables local governments to make independent

and scientific decisions in an emergency.

Keywords

evidence-based decision-making, public health policy, local government, COVID-19, China